Oral Gabapentin in Management of Chronic Pelvic Pain in Females Randomized Controlled Trial

Abstract

C hronic pelvic pain (CPP) is defined by the Royal College of Obstetricians and Gynecologists as 'intermittent or constant pain in the lower abdomen or pelvis of a woman of at least 6 months in duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy (Green-top Guideline No. 41. London: RCOG; 2012). Anticonvulsant drugs also appear to act through a combination of mechanisms, including inhibition of voltage-gated sodium and calcium channels and interactions with the γ-amino butyric acid (GABA) system (McMahon et al., 2013). Gabapentin [1-aminomethyl cyclo-hexanacetic acid] and pregabalin are anticonvulsant drugs that have been used anecdotally in patients with CPPS. They are commonly used to treat various other neuropathic pain syndromes, including diabetic neuropathy, postherpetic neuralgia, and fibromyalgia. Results from the trial of Pregabalin in CPPS were reported at the 2009 American Urological Association (AUA) Meeting (Pontari et al., 2009). After 6 weeks of Pregabalin therapy, this treatment was not superior to placebo for the alleviation of CPPS symptoms. However, statistically significant improvement was observed in a number of secondary end points.